To live an ordinary life: resource needs and additional costs for people with a physical impairment

Disabled people face increased risks of living in poverty largely due to lower incomes and extra resource requirements compared to non-disabled people. This study incorporated the social model of disability with an economic approach to costing to estimate the additional costs required by people with a physical impairment to achieve an adequate standard of living in New Zealand. Budgets estimating the additional equipment, modifications, transport, support and time required to achieve an adequate standard of living were developed and validated through focus groups with community members. The findings suggest that reducing barriers involves substantial costs ranging from NZ$645–$2,348 per week.     

Understanding public attitudes towards Social Security

There has been very little research on why individuals hold different attitudes toward Social Security. In this article we integrate social location theory and political predisposition theory to provide a framework of explanation and test these theories using a unique sample from the 1998 General Social Survey. Our multivariate results reveal that social structural positions along the lines of race, gender, class and age play a more important role than political predispositions in explain-ing individual differences in support for the current Social Security system against privatisation. Political party affiliation also partly contributes to variation in support for Social Security, but political ideology does not have a significant effect. Our results suggest that with regard to support for Social Security, primary consideration must rest on social structural positions. Racial minorities, women, the poor and the elderly tend to dislike a drastic change in the current Social Security system, and Social Security reform ought to pay attention to their concerns. Our robust finding of a positive relationship between age and support for Social Security also challenges much of the established knowledge, pointing to an intergenerational discord over Social Security. It is also important to differentiate among social welfare programmes in order to uncover the real determinants of public attitudes towards them.     

Palliative sedation: an essential place for clinical excellence

The complexities that converge around palliative sedation invite clinicians to work together to differentiate the issues and come to recommendations and decisions that are humane, ethical, legal, and clinically sound. Whether a crisis or long-term situation exists, the work is essentially the same. It must include critical thinking, clinical expertise, multidimensional assessment, and an array of interventions to assist patients and families in situations where symptoms and suffering are sufficiently intense to warrant exploration of sedation. The many issues inherent in the discussion of sedation at end of life require not that we have the answers but rather that we work with our colleagues to raise relevant questions and integrate both expertise and compassion into end-of-life decisions and care.     

Medical Negligence and Resource Allocation in the NHS

The recent growth in medical malpractice claims and in awards for damages has created concern both amongst doctors and health administrators. Steps which have been taken by the Review Body on Doctors’and Dentists’Remuneration and policy now advocated by the BMA suggest a movement away from the current system of negligence and towards a stricter no-fault system of liability. Under the current system, medical negligence occurs when doctors have not met the standards of treatment expected by reference to current professional standards. Under a no-fault system patients would be entitled to compensation for losses which arise from treatment, irrespective of whether negligence had occurred; although the implication is that the amounts of compensation would necessarily be limited. While there are reasons to believe that financial difficulties for doctors and pressures on NHS budgets may be ameliorated by a no-fault system, there are other criteria against which the current system of negligence should be judged. This article attempts to provide a framework within which a negligence system may be assessed. In particular, attention is drawn to the educative role of a negligence system and to the provision of information which may improve decisions on resource allocation. A critique of the current system of medical negligence in the UK suggests that a package of reforms to improve the system would be better than further movements towards non-market solutions.     

Australian University Students' Views of the Nuclear Arms Race: Comparative and Qualitative Analyses

Australian university students' views of the nuclear arms race were analysed in two studies. A sample comparison study used Nuclear Arms Race Questionnaire (NARQ) and Position on Nuclear Weapons (PNW) scales to compare university students' views with those of high school students and community groups. University students' views were more strongly anti-nuclear than middle income and Middle European migrant groups, but not more than high school student and church member groups'. Females' attitudes were more strongly anti-nuclear than males. A qualitative analysis of ten university students' formulations of the arms races problem and Australia's involvement revealed the complex dimensions of perceived relationships between global and national interests and personal nuclear issues. Students' solutions were directly related to their formulations of the major aspects of the arms race problem, with six students who represented the nuclear problem in terms of superpower conflict, seeing individuals as powerless to influence solutions. Quantitative trends are interpreted in light of the varied representations of the problem and the association of students' generally anti-nuclear attitudes with lack of involvement in the peace movement.     

China's Below‐Replacement Fertility: Recent Trends and Future Prospects

Between 1970 and 1990, China experiencoed a rapid and sharp fertility decline—from total fertility rates of approximately six births to two. The degree to which Chinese fertility has continued to fall after 1990 is controversial. We use survey data from the 1997 National Population and Reproductive Health Survey and from the 2001 Reproductive Health and Family Planning Survey to document recent trends in Chinese fertility. Our estimates provide further evidence that China's fertility is well below‐replacement level at the turn of the twenty‐first century—with TFR levels of approximately 1.5 children per woman. Trends in parity‐specific cohort fertility by age also suggest below replacement completed fertility for cohorts still in the childbearing years. In the article's second section, we identify key components of low period fertility in order to frame our discussion of two questions: 1) in what ways is Chinese low fertility different from/similar to that in other low‐fertility countries? And 2) what are the likely future trends in Chinese fertility?     

The Correspondence Between Fertility Intentions and Behavior in the United States

Using data from the 1979 National Longitudinal Survey of Youth, we describe the correspondence between intended family size and observed fertility for US men and women in the 1957–64 birth cohorts. Mean fertility intentions calculated from reports given in the mid‐20s modestly overstate completed fertility. But discrepancies between stated intent and actual fertility are common—the stated intent at age 24 (for both women and men) is more likely to miss than to match completed fertility. We focus on factors that predict which women and men will have fewer or more children than intended. Consistent with life‐course arguments, those unmarried, childless, or (for women) still in school at approximately age 24 were most likely to underachieve their intended parity (i.e., had fewer children than intended at age 24). We discuss how such discrepancies between intentions and behavior may cumulate to produce sizable cross‐group fertility differences.